Assessing quality of life in palliative care settings: head-to-head comparison of four patient-reported outcome measures (EORTC QLQ-C15-PAL, FACT-Pal, FACT-Pal-14, FACT-G7)

Madeleine T King¹, Meera Agar^{2

3

4}, David C Currow^{2

5}, Janet Hardy⁶, Belinda Fazekas^{2

7}, Nikki McCaffrey⁸

Affiliations

¹ School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia. madeleine.king@sydney.edu.au.
² IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Sydney, Australia.
³ South West Sydney Clinical School, University of New South Wales, Sydney, Australia.
⁴ Ingham Institute of Applied Medical Research, Sydney, Australia.
⁵ Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, England.
⁶ Department of Palliative and Supportive Care, Mater Health Services, Mater Research -University of Queensland, Brisbane, Queensland, Australia.
⁷ Discipline of Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia.
⁸ Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.

PMID: 30993452
DOI: 10.1007/s00520-019-04754-9

Assessing quality of life in palliative care settings: head-to-head comparison of four patient-reported outcome measures (EORTC QLQ-C15-PAL, FACT-Pal, FACT-Pal-14, FACT-G7)

Madeleine T King et al. Support Care Cancer. 2020 Jan.

. 2020 Jan;28(1):141-153.

doi: 10.1007/s00520-019-04754-9. Epub 2019 Apr 16.

Authors

Madeleine T King¹, Meera Agar^{2

3

4}, David C Currow^{2

5}, Janet Hardy⁶, Belinda Fazekas^{2

7}, Nikki McCaffrey⁸

Affiliations

¹ School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia. madeleine.king@sydney.edu.au.
² IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Sydney, Australia.
³ South West Sydney Clinical School, University of New South Wales, Sydney, Australia.
⁴ Ingham Institute of Applied Medical Research, Sydney, Australia.
⁵ Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, England.
⁶ Department of Palliative and Supportive Care, Mater Health Services, Mater Research -University of Queensland, Brisbane, Queensland, Australia.
⁷ Discipline of Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia.
⁸ Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.

PMID: 30993452
DOI: 10.1007/s00520-019-04754-9

Abstract

Purpose: Head-to-head comparison of reliability, validity and responsiveness of four patient-reported outcome measures (PROMS) suitable for assessing health-related quality of life (HRQOL) in palliative care settings: EORTC QLQ-C15-PAL, FACT-G7, FACIT-Pal and short-form FACIT-Pal-14.

Methods: Secondary analysis of two phase III randomised trials: ketamine for chronic cancer pain, octreotide for vomiting in inoperable malignant bowel obstruction. Sub-groups were defined by Australia-modified Karnofsky performance status (AKPS) and participants' global impression of change (GIC). Two aspects of reliability were assessed: internal consistency (Cronbach alpha, α); test-retest reliability (intra-class correlation coefficient (ICC)) of patients with stable AKPS and those who self-reported 'no change' on GIC. Construct validity was assessed via pre-determined hypotheses about sensitivity of PROM scores to AKPS groups and responsiveness of PROM change scores to GIC groups using analysis of variance.

Results: FACIT-Pal had better internal consistency (α ranged 0.59-0.80, 15/18 ≥ 0.70) than QLQ-C15-PAL (0.51-0.85, 4/8 ≥ 0.70) and FACT-G7 (0.54-0.64, 0/2 ≥ 0.70). FACIT scales had better test-retest reliability (FACIT-Pal 11/27 ICCs ≥ 0.70, FACT-G7 2/3 ICCs ≥ 0.70) than QLQ-C15-PAL (2/30 ICCs ≥ 0.70, 18/30 ≤ 0.5). Four scales demonstrated sensitivity to AKPS: QLQ-PAL-15 Physical Functioning and Global QOL, FACT-G Functional Wellbeing and FACIT-Pal Trial Outcome Index (TOI). Nine scales demonstrated responsiveness: three in the ketamine trial population (QLQ-C15-PAL Pain, FACIT-Pal-14, FACT-G7), six in the octreotide trial population (QLQ-C15-PAL Fatigue; FACIT-Pal PalCare, TOI, Total; FACT-G Physical Wellbeing and Total).

Conclusions: No PROM was clearly superior, confirming that choosing the best PROM requires careful consideration of the research goals, patient population and the domains of HRQOL targeted by the intervention being investigated.

Keywords: EORTC QLQ-C15-PAL; FACIT-Pal; FACIT-Pal-14; FACT-G7; Patient-reported outcome measures; Quality of life.

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References

1. World Health Organization (2015) Definition of palliative care. http://www.who.int/cancer/palliative/definition/en/ . Accessed July 14 2015
1. FDA (2009) Food and Drug Administration. Guidance for industry on patient-reported outcome measures: use in medical product development to support labeling claims. Fed Regist 74(235):65132–65133
1. Reeve BB, Wyrwich KW, Wu AW, Velikova G, Terwee CB, Snyder CF, Schwartz C, Revicki DA, Moinpour CM, McLeod LD, Lyons JC, Lenderking WR, Hinds PS, Hays RD, Greenhalgh J, Gershon R, Feeny D, Fayers PM, Cella D, Brundage M, Ahmed S, Aaronson NK, Butt Z (2013) ISOQOL recommends minimum standards for patient-reported outcome measures used in patient-centered outcomes and comparative effectiveness research. Qual Life Res 22(8):1889–1905. https://doi.org/10.1007/s11136-012-0344-y - DOI - PubMed
1. Aaronson N, Alonso J, Burnam A, Lohr KN, Patrick DL, Perrin E, Stein RE (2002) Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res 11(3):193–205 - DOI
1. Osoba D (1994) Lessons learned from measuring health-related quality of life in oncology. J Clin Oncol : Off J Am Soc Clin Oncol 12(3):608–616. https://doi.org/10.1200/jco.1994.12.3.608 - DOI

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Assessing quality of life in palliative care settings: head-to-head comparison of four patient-reported outcome measures (EORTC QLQ-C15-PAL, FACT-Pal, FACT-Pal-14, FACT-G7)

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Assessing quality of life in palliative care settings: head-to-head comparison of four patient-reported outcome measures (EORTC QLQ-C15-PAL, FACT-Pal, FACT-Pal-14, FACT-G7)

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